coronary arteritis


cor·o·nar·y ar·te·ri·tis

inflammation of any or all of the layers of coronary artery walls.

Kawasaki syndrome

An acute idioapathic febrile illness that primarily affects children under age 5, especially males, and has a winter-spring seasonality.
Clinical findings
Fever; cervical lymphadenopathy; palmoplantar and mucosal erythaema and oedema; conjunctivitis; gingivitis; maculoerythematous glove-and-sock rash over the hands and feet, which becomes hard, oedematous and sloughs; aneurysms of small- and medium-sized coronary, occasionally peripheral, arteries, with arteritis. Other findings include conjunctival oedema, upper respiratory tract oedema, pharyngeal injection and truncal lymphadenopathy.
 
Aetiology
Uncertain; various bacteria have been implicated, though none definitively.
 
Lab
Increased ESR, CRP, complement, immunoglobulins.
 
Management
Gammaglobulin in IV bolus, aspirin IV.
 
Prognosis
May cause sudden death; 1–5% die of disease.
Kawasaki syndrome case definition (CDC)
Fever of 5 days’ duration (or fever post-IV immunoglobulin if given before 5th day of fever), and 4 of following 5 signs:
• Rash; 
• Cervical lymphadenopathy (1.5+ cm in diameter);
• Bilateral conjunctival injection; 
• Oral mucosal changes—erythaema, fissuring and xerostomia, “strawberry tongue”; 
• Peripheral extremity changes—e.g., acral erythema or oedema, periungual and/or generalised desquamation, polymorphous exanthematous rash.